Tiruye Tenaw, O'Callaghan Michael, Ettridge Kerry, Moretti Kim, Jay Alex, Higgs Braden, Santoro Kerry, Kichenadasse Ganessan, Beckmann Kerri
Cancer Epidemiology and Population Health Research Group, Allied Health and Human Performance University of South Australia Adelaide Australia.
Public Health Department Debre Markos University Debre Markos Ethiopia.
BJUI Compass. 2023 Sep 12;5(1):109-120. doi: 10.1002/bco2.288. eCollection 2024 Jan.
To describe real-world clinical and functional outcomes in an Australian cohort of men with localised prostate cancer according to treatment type and risk category.
Men diagnosed from 2008 to 2018 who were enrolled in South Australian Prostate Cancer Clinical Outcomes Collaborative registry-a multi-institutional prospective clinical registry-were studied. The main outcome measures were overall survival, cancer-specific survival, decline in functional outcomes, biochemical recurrence and transition to active treatment following active surveillance. Multivariable adjusted models were applied to estimate outcomes.
Of the 8513 eligible men, majority of men (46%) underwent radical prostatectomy (RP) followed by external beam radiation therapy with or without androgen deprivation therapy (EBRT +/- ADT) in 22% of the cohort. Five-year overall survival was above 91%, and 5-year prostate cancer-specific survival was above 97% in the low- and intermediate-risk categories across all treatments. Five-year prostate cancer-specific survival in the active surveillance group was 100%. About 37% of men with high-risk disease treated with RP and 17% of men treated with EBRT +/- ADT experienced biochemical recurrence within 5 years of treatment. Of men on active surveillance, 15% of those with low risk and 20% with intermediate risk converted to active treatment within 2 years. The decline in urinary continence and sexual function 12 months after treatment was greatest among men who underwent RP while the decline in bowel function was greatest for men who received EBRT +/- ADT.
This contemporary real-world evidence on risk-appropriate treatment outcomes helps inform treatment decision-making for clinicians and patients.
根据治疗类型和风险类别，描述澳大利亚一组局限性前列腺癌男性患者的真实世界临床和功能结局。
对2008年至2018年确诊并纳入南澳大利亚前列腺癌临床结局协作登记处（一个多机构前瞻性临床登记处）的男性患者进行研究。主要结局指标包括总生存期、癌症特异性生存期、功能结局下降、生化复发以及主动监测后转为积极治疗的情况。应用多变量调整模型来估计结局。
在8513名符合条件的男性中，大多数男性（46%）接受了根治性前列腺切除术（RP），22%的队列患者接受了有或无雄激素剥夺治疗的外照射放疗（EBRT±ADT）。在所有治疗方法的低风险和中风险类别中，5年总生存率高于91%，5年前列腺癌特异性生存率高于97%。主动监测组的5年前列腺癌特异性生存率为100%。接受RP治疗的高危疾病男性中约37%以及接受EBRT±ADT治疗的男性中17%在治疗后5年内出现生化复发。在接受主动监测的男性中，低风险者有15%、中风险者有20%在2年内转为积极治疗。治疗后12个月，接受RP的男性尿失禁和性功能下降最为明显，而接受EBRT±ADT的男性肠功能下降最为明显。
这一关于风险适配治疗结局的当代真实世界证据有助于为临床医生和患者的治疗决策提供参考。
